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Complications of tympanostomy tubes in an inner city clinic population
N A Goldstein1, J T Roland, N Sculerati
1Department of Otolaryngology, New York University School of Medicine, NY 10016, USA.
Insights
Tympanostomy tube insertion is a safe option for children with recurrent ear infections, showing minimal complications in an urban clinic. This procedure effectively improves hearing in pediatric patients.
Area of Science:
- Pediatric Otolaryngology
- Otolaryngology
- Pediatrics
Background:
- Recurrent acute otitis media (AOM) and otitis media with effusion (OME) are common in children.
- Prophylactic antibiotics and tympanostomy tube insertion are treatment options.
- Previous studies indicated poor antibiotic compliance in urban pediatric populations.
Purpose of the Study:
- To evaluate the complication rates of tympanostomy tube insertion in a pediatric urban clinic.
- To assess the safety and efficacy of tympanostomy tubes in a population with potentially low antibiotic compliance.
Main Methods:
- Retrospective review of 391 tympanostomy tube insertions in 165 pediatric patients.
- Analysis of complications including persistent perforations, tympanosclerosis, retraction, cholesteatoma, and otorrhea.
- Assessment of hearing outcomes (pure tone average) before, during, and after tube placement.
Main Results:
- A low incidence of complications was observed: 1.14% persistent perforations, 11.1% tympanosclerosis, and 1.70% postoperative otorrhea.
- No cases of chronic retraction or cholesteatoma were reported.
- Significant hearing improvement was noted, with mean pure tone average improving from 25.0 dB to 2.44 dB with tubes in place.
Conclusions:
- Tympanostomy tube insertion demonstrates a minimal complication profile in an inner-city pediatric population.
- The procedure is effective in improving hearing for children suffering from recurrent otitis media.
- Tympanostomy tubes offer a viable treatment alternative in settings with concerns about antibiotic compliance.
Abstract:
While both prophylactic antibiotics and tympanostomy tube insertion have a role in the treatment of recurrent acute otitis media (AOM) and otitis media with effusion (OME) in children previous work has shown that patients in our urban clinic are not compliant with prophylactic antibiotics. Concerned about the potential for decreased compliance in a non-compliant population, we performed a retrospective review to assess the incidence of complications from the insertion of tympanostomy tubes in the same pediatric clinic population. A total of 391 tubes were placed in 165 patients. Follow-up ranged from 0-49.4 months with a mean of 21.3 months. Three ears (1.14%) had persistent perforations. Tympanosclerosis was found in 30 ears (11.1%). No ear showed a chronic retraction or cholesteatoma. Six ears (1.70%) developed postoperative otorrhea. Thirty-five patients had at least one episode of otorrhea outside of the perioperative period, and a total of 60 episodes (19.6% of ears) occurred during the study period. The mean pure tone average prior to tube placement was 25.0 dB, with tubes in place was 2.44 dB and after the last set of tubes had extruded was 6.97 dB. Our study shows that the incidence of complications of tympanostomy tubes was minimal in our inner city clinic population.